A rapid scoping review of barriers and facilitators of implementing delirium prevention practices in adult critical care.

Background: Delirium is a serious complication of critical care that can have lasting effects on the patient’s life. Much of the work to date about delirium has been focused on identifying delirium risk factors, developing tools for screening and recognizing delirium, and testing interventions to treat those diagnosed with delirium. Despite evidence, implementing known delirium prevention and management strategies remains abysmal. This review aimed to identify and summarize literature reporting on the barriers and facilitators of implementing delirium prevention and management practices in adult critical care. Methods: A rapid scoping review of the literature was conducted. The databases CINAHL and Ovid Medline were searched, and forward and backward reference checking was completed. Data abstraction and analysis were performed by one reviewer and verified by a second reviewer. Results: After review of 74 full-text papers, 32 articles were included in the review. The articles were published between 2008 and 2022, with the majority conducted in the United States (53%). The barriers and facilitators of delirium prevention and management practices described in the reviewed articles were categorized as patient-level, clinician-level, and organizational-level factors. Conclusion: The review found consistency among the published results. However, opportunities to continue to grow research in this area remain; specifically in examining the opportunity to understand better the decision-making process surrounding how care is prioritized when taking into consideration the present barriers and facilitators and the opportunity to use implementation science to create and sustain change in the practice of delirium prevention and management strategies. [ABSTRACT FROM AUTHOR]